Provider Demographics
NPI:1942781331
Name:DEMKE, ELAINE LUPE (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:LUPE
Last Name:DEMKE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-1605
Mailing Address - Country:US
Mailing Address - Phone:405-210-2031
Mailing Address - Fax:
Practice Address - Street 1:3700 N CLASSEN BLVD STE 185
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2881
Practice Address - Country:US
Practice Address - Phone:405-225-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist